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脉冲骑乘装置辅助栓塞宽颈分叉动脉瘤:国际系列研究中的围手术期结果

PulseRider Stent-Assisted Coiling of Wide-Neck Bifurcation Aneurysms: Periprocedural Results in an International Series.

作者信息

Gory B, Spiotta A M, Mangiafico S, Consoli A, Biondi A, Pomero E, Killer-Oberpfalzer M, Weber W, Riva R, Labeyrie P E, Turjman F

机构信息

From the DHU IRIS, Department of Interventional Neuroradiology (B.G., R.R., P.E.L., F.T.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France

Department of Neurosciences (A.M.S.), Division of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina.

出版信息

AJNR Am J Neuroradiol. 2016 Jan;37(1):130-5. doi: 10.3174/ajnr.A4506. Epub 2015 Sep 3.

Abstract

The PulseRider is a novel endovascular device specifically designed to treat bifurcation intracranial aneurysms with wide necks. In an international series, we report the results of PulseRider stent-assisted coiling of 15 patients (9 women and 6 men; mean age, 62.6 years) with 15 unruptured wide-neck (median dome size, 8 mm; median neck size, 5 mm) bifurcation aneurysms. Failure of PulseRider treatment occurred in 1 case, and 1 intraprocedural thromboembolic complication was observed. There was no mortality or neurologic permanent morbidity at discharge and at 1 month. Immediate angiographic outcome showed 12 complete occlusions and 2 neck remnants. Follow-up at 6 months was available for 3 aneurysms and demonstrated 2 complete aneurysm occlusions and 1 growing neck remnant. In this small series of selected patients, PulseRider stent-assisted coiling of wide-neck bifurcation aneurysms was feasible with low procedural complication rates. Angiographic follow-up will be required to evaluate the efficacy of the PulseRider device.

摘要

脉冲支架(PulseRider)是一种专门设计用于治疗宽颈分叉颅内动脉瘤的新型血管内装置。在一项国际研究中,我们报告了15例(9例女性和6例男性;平均年龄62.6岁)未破裂宽颈(瘤顶大小中位数为8mm;瘤颈大小中位数为5mm)分叉动脉瘤患者采用脉冲支架辅助弹簧圈栓塞治疗的结果。脉冲支架治疗失败1例,观察到1例术中血栓栓塞并发症。出院时及1个月时无死亡或永久性神经功能缺损。即刻血管造影结果显示12例完全闭塞,2例瘤颈残留。3个动脉瘤有6个月的随访,显示2例动脉瘤完全闭塞,1例瘤颈残留增大。在这一小系列特定患者中,脉冲支架辅助弹簧圈栓塞宽颈分叉动脉瘤是可行的,手术并发症发生率低。需要进行血管造影随访以评估脉冲支架装置的疗效。

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